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    Old 09-15-2011, 01:36 PM   #1
    meg52
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    MRI help

    Hi all

    I need a little help from you seasoned veterans on figuring out what my
    MRI means. Oh and by the way...I was never told any of this by my Dr.
    or physiatrist. I WAS told I had shoulder tendonitis.
    Thanks in advance for any help!

    I will post the report below:
    MR CERVICAL SPINE WITHOUT CONTRAST

    Findings: There is cervical straightening. No compression fractures are noted within the
    cervical spine. Cord signal is within normal limits. The individual cervical levels are as follows:

    C2-C3: Mild disc dessication. No central canal or neural frontal stenosis.

    C3-C4: Central canal 9 mm. Posterolateral spurring results in mild to moderate neuroforaminal
    narrowing bilaterally.

    C4-C5: Central canal measures 9 mm. Posterolateral spurring results in moderate neuroforaminal
    narrowing bilaterally, right greater left.

    C5-C6: There is moderate disc degeneration and disc space narrowing with a moderately large broad-based right posterolateral disc protrusion. Central canal is narrowed to 8 mm. Posterolateral spurring results in moderate left and severe right neural foraminal narrowing.

    C6-C7: There is a broad based posterocentral disc protrusion which effaces the ventral CSF and flattens the cord. The central canal is narrowed to 6 mm. Posterolateral spurring causes severe right and moderate left neural foraminal narrowing.

    C7-T1: The central canal measures 10 mm. Posterolateral spurring results in moderate neural foraminal bilaterally.

    IMPRESSION

    1. Moderate spinal stenosis at C6-C7 secondary to moderately large broad-based posterocentral disc protrusion.
    2. Mild to moderate spinal stenosis at C5-C6 secondary to disc degeneration and moderately large broad-based right posterolateral disc protrusion.
    3. Mild spinal stenosis C3-C4 and C4-C5. Central canal low normal at T7-T1

    (there is no # 4)
    5.Multiple levels of neural foraminal narrowing as described, most severe at C5-C6 and C6-C7.

     
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    Old 09-15-2011, 02:19 PM   #2
    meg52
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    Re: MRI help

    It's still me.
    I figured I should explain a little more.

    This MRI is a few years old. What got my Dr to send me for the MRI was
    a second acute attack of left shoulder pain so severe I couldn't move the arm. I was sent for x-rays of the shoulder and the cervical MRI. I was then
    referred to a physiatrist who ended up giving me a cortisone shot.
    Happily...I was pain free for 3 months.
    Prior to this I had very bad pain in both shoulders all the time with intermittent
    numbness and tingling. The ring and baby finger on my left hand have had a loss of feeling for about 5 years now. I have told all of this to 4 Dr's and a
    chiropractor repeatedly. In addition...over the past few years I have developed pain and stiffness in the neck and always feel mildly dizzy. The pain
    in both shoulders has never gone away. My Dr said it never will. "You just have to live with it"
    At the end of August I had another severe attack of pain and immobility in the
    left shoulder. I ended up going to the walk in clinic and getting another cortisone shot. Unfortunately...this one didn't work. Within 2 days I was unable to move the arm and needed help to dress and use the toilet.
    I called my Dr's office (quite scared) and they finally got back to me 5 hours
    later (and 2 more calls from my hubby) They said it was a cortisone flair and it
    would settle down. This time however...he wants me to consult with Orthopedics. I have an appointment in 10 days. I also have bad lumbar problems but that's another story. I will leave it at this for now.

     
    Old 09-15-2011, 05:27 PM   #3
    WebDozer
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    Re: MRI help

    Good grief..... you had an MRI "a few years ago" that showed moderate to SEVERE problems at multiple levels and they just let you walk off?

    You need another MRI, and you need it NOW!! If your doc won't send you for one, ditch him and find one who will. (my amateur opinion, which may not be worth much more than you paid for it).

    I will comment on your MRI, but you REALLY need a new one. How many years ago was the other, do you know? Things like spinal stenosis and foraminal narrowing are unlikely to go away just because you try to out-wait them.

    As for the MRI, I'm surprised that you are having left-side problems. Everything you are describing that's happening on your left side is what I would expect to happen on your right side, just based on the MRI. Another indication that things have changed enough so that you really need to update the MRI.

    (as an aside... 15 years ago I went to my GP complaining of right shoulder pain which I thought might be a rotator cuff, or maybe just tendonitis. He took an X-ray and got me an appointment with a neurologist the next day, who got me an MRI that afternoon. The neuro then called in for the radiologist's report and called me to go to the hospital and pick up the MRI personally to take to a neurosurgeon the next day for an emergency appointment. I was having surgery the following week. Turns out my spinal cord was 50% compressed. The word "severe" cropped up in my report, just as it did in yours.)

    Just a bit of background, in case you don't already know. Your spine consists of vertebrae and disks stacked on top on one another like plates. BEHIND this stack is a bony cage that holds your spinal CANAL. Your canal should be about 15-16mm. The canal is filled with fluid, and inside the fluid is the spinal CORD - the nerve pathway - which should be 8-10 mm. Many people (I, for one) are born with too-narrow canals, a condition known as congenital spinal stenosis (narrowing). A person with this condition may have no problems at all until middle age. Over time, though, things can intrude on the canal. Inflamed ligaments, bone spurs (osteophytes) and disks. The most common complaint is that disks are forced backwards back into the spinal canal.

    As you can see, someone with a normal spinal canal has some leeway for things to intrude on the canal w/o impinging on the cord. Someone with congenital stenosis does not have this leeway, and thus is much more readily susceptible to those problems caused by disks, osteophytes and ligaments.

    Ideally, the cervical spine curves backwards (lordosis). If it is straightened, then there's abnormal pressure on the FRONT of the vertebrae, which can push the disks out the BACK. (I think it may be something of a chicken/egg thing, though, as disks being displaced can also cause the spine to straighten.

    I'll continue this on another post, in a minute or two....

    Last edited by WebDozer; 09-15-2011 at 05:31 PM.

     
    Old 09-15-2011, 07:03 PM   #4
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    Re: MRI help

    (continuing)

    inadvertent duplication

    Last edited by WebDozer; 09-15-2011 at 07:14 PM.

     
    Old 09-15-2011, 09:25 PM   #5
    meg52
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    Re: MRI help

    Hi WebDozer

    Thanks so much for your response!
    I kinda had the feeling that this should have been investigated further.
    The MRI is actually 5 years old. However the first time I saw the report was
    one year ago when I started seeing a chiropractor.

    I asked for a copy of the MRI and when I viewed it, up came this report!
    As I mentioned, I have expressed concern about this to 4 Dr's (one being
    my Pain Management Dr.) They all just kind of give me a blank stare and
    say hmmm. The only one who seemed concerned was the chiro.

    I am starting to think my PM Doc hasn't even looked at the MRI as he sure acts like he doesn't believe I'm in pain. You see...I am un-insured so perhaps
    they haven't bothered to do any more because of this? If that's the case...I
    think it's very unprofessional as I should at least have been informed so I could make some decisions. I am very happy that my GP has referred me to ortho though. Seems like this may have been in order 5 years ago!
    However...LOL...I was told 27 years ago by an Orthopedic surgeon that I had
    scoliosis and would likely need surgery at age 40. (53 now)
    I had chocked up a lotta years of pain to the scoliosis. I was told last year by my Chiro that I do not have scoliosis. I have seen the x-rays and my spine does look pretty straight.
    Really hoping I can get some correct answers from the Ortho.

     
    Old 09-16-2011, 05:25 AM   #6
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    Re: MRI help

    HealthBoards somehow destroyed the second half of my response. Hopefully I will get time to re-type it.

    Being w/o insurance could certainly be a factor for you. The docs don't want to send you down a path that requires surgery, however much you might need it, because they think you won't be able to afford it.

     
    Old 09-17-2011, 07:35 AM   #7
    WebDozer
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    Re: MRI help

    As to the specifics of the MRI:

    1. You have bone spurs coming into your foraminal openings - on both sides - all the way from C3 down to C7. Make particular note of the adjectives, as radiologists use none/minimal/mild/moderate/severe to indicate the seriousness of a problem. Something that's "moderate" should be monitored (at least), while something that's "severe" should be fixed.
    When spurs grow into the foraminal openings, they can impinge upon the the peripheral nerves as they leave the spinal cord and head down to your shoulders and arms. This is a condition often known as "radiculopathy", meaning "a problem with the root". This impingement can cause problems going in both directions. Affecting outbound nerves can cause motor and strength problems, while affecting inbound nerves can cause sensations to be reported to the brain which do not actually come from the arms and shoulders, but rather from the nerve roots up in the cervical spine.

    2. You have two disks - C5-6 and C6-7 - that are protruding backward into the spinal canal. When they do this, they push on the canal and push away (efface) the spinal fluid (CSF) in the front (ventral) part of the canal. If they push far enough back, they affect not just the canal, but the spinal cord within the canal.

    3. The C5-6 disk does not yet (at the time of the MRI) seem to be affecting the spinal cord. It has squeezed the canal down to a width of 8mm, though, which is quite narrow. Your spinal canal should be maybe twice that wide, ideally. The spinal cord itself shouldn't be less than 8mm.

    4. The C6-7 disk is the worst. It has protruded back so far that it is actually flattening the spinal cord and squeezing it down to a very narrow 6mm. This could be causing all kinds of problems with any of the nerves from this level down, which includes some of your arm nerves and all of the nerves below the shoulders.

    5. As this MRI is five years old, one should assume that most, if not all, of the problems mentioned are at least as bad now, and likely worse. While protruding disks can sometimes be resorbed back to their proper location, bone spurs will never get better on their own, and likely will continue to grow.

    I don't know how to advise you with the insurance/financial aspects of this, but strictly from a medical point of view I think it's VERY advisable to get a new MRI so a better assessment of your current condition can be made.

    Last edited by WebDozer; 09-17-2011 at 07:36 AM.

     
    Old 09-17-2011, 02:44 PM   #8
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    Wink Re: MRI help

    WebDozer you give amazing explanations when dealing with an MRI. Wish I had placed my MRI results on this site 6 years ago. You explain things so all can understand. You are a wealth of knowledge.

     
    Old 09-17-2011, 03:00 PM   #9
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    Re: MRI help

    ff, that's kind of you to say, but I hope that EVERYONE reading what I write will keep in mind that I'm just an amateur who's attempting to apply a little common sense, a little internet research, and a little too much personal experience......

     
    Old 09-17-2011, 07:02 PM   #10
    meg52
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    Re: MRI help

    thanks again Webdozer! You certainly ARE a wealth of information.
    I am sure the Ortho will want a new MRI.
    I am still stunned though, that none of this was mentioned to me at the time...or since
    come to think of it.
    I was sent away with a diagnosis of calcific tendonitis in my left shoulder.
    I am starting to wonder if all my other back problems are coming from the cervical spine.

    I will be bringing the disk of the MRI and x-rays with me to the Ortho appointment.
    I'll let you know how it goes. Thanks!

     
    Old 10-12-2011, 01:45 PM   #11
    meg52
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    Re: MRI help

    This is a follow up on my appointments.

    So I went to see the Ortho, who was actually a PA but seemed to really know his stuff.
    As he was focusing on the shoulder problem following a cortisone shot and BAD flair, he suggested we do a lidocaine shot and see if that relieved the pain. It didn't so he said doing another cortisone shot would be a waste of time. After reviewing my records etc he wanted me to go see a spine specialist. okay...booked an appointment.
    Last week I saw the spine specialist.
    This is where I am very surprised at his diagnosis. He had all my records on his laptop computer. My 5 year old MRI and xrays. I had brought a disc with xrays of the cervical and lumbar done at my chiropractor's last year, along with chiro's report.
    He didn't even want to look at those.
    He did some examination...reflexes...sensation in my hands...asked me if it hurt when I bend over (yes) had me turn my head side to side. That's about it.
    I had printed out the MRI report and highlighted the part about the "flattens the cord"
    I gave it to him and told him I was very concerned about that.
    His response was..."Ah that's nothing"
    He said he thinks if I just get more exercise things will get better!
    Now I agree I could use more exercise. I just have to power thru the pain to do that.
    He suggested all the usual stuff...massage, PT (at home) and tylenol or advil.
    So...all that damage on the old MRI and this is what he suggests? He didn't even think a new MRI was needed.
    Maybe I am wrong but 20 plus years of pain...numbness...tingling...dizziness etc just doesn't strike me as something that will magically fix itself with a little more exercise.
    So this is where I'm at.
    Kinda baffled actually.

     
    Old 10-12-2011, 04:24 PM   #12
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    Re: MRI help

    You had SEVERE FORAMINAL STENOSIS and CANAL FLATTENED TO 6MM, all this on an MRI that's FIVE YEARS OLD, and he didn't even order another MRI? I'm not baffled... I am stunned.

    I really think you AT LEAST need another MRI, and someone different to look at it. If ANYONE here disagrees, I would love to hear, because this has me doubting all I thought I knew on this subject.

     
    Old 10-12-2011, 08:36 PM   #13
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    Re: MRI help

    Oh I agree Web D...I am kinda stunned too.
    I thought for sure that would be the first thing he wanted.
    Even an xray would be better than nothing for the lumbar problems.
    Didn't want those either
    ???????? Really not sure how to proceed from here.

     
    Old 10-12-2011, 09:51 PM   #14
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    Re: MRI help

    The only thing I can think of is to tell your GP that you want another cervical MRI and you want him to refer you to someone who will order it. For the time being, you don't want to talk to doctors, you just want another MRI. Take the radiologist's report with you and underline all the problem areas and emphasize that it's five years old.

    Another suggestion would be to take your husband along when talking to doctors. Just there being two of you may make the docs treat you with a little more consideration.

    I'm not saying, by the way, that another MRI will necessarily do much good, but I know for sure that that's what I would want if in your shoes....

     
    Old 12-28-2011, 11:51 AM   #15
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    Re: MRI help

    Hi All,

    I've been reading Meg's and Webdozer's blog about Meg's problem of not getting the support and treatment she requires. My situation is not as severe, but I'm in such pain and this is all because of an injury in 2009. Are you able to see my profile? I posted my story and summary of events from then until now.

    Help! Please, I'm so desperate...

    Natalie

     
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